"合同式健康全程管理示范干预"效果及影响因素研究

目的 探讨以家庭医生为主线，以家庭为单位进行“合同式健康全程管理示范干预”的模式，并观察干预前、后的效果。方法 2003年8月～2004年12月选择自愿与家庭医生签约的60户(205人)家庭，干预前、后使用统一的生活方式与行为危险因素调查问卷，经逻辑核查后，用EPI5软件建立数据库，用SPSS进行数据分析，根据家庭卫生诊断所暴露的主要卫生问题进行分层干预管理，对于健康知识知晓率、危险因素流行率、健康行为的改变进行效果评价。结果 60户签约家庭干预前、后9种知识知晓率明显提高(P＜0．01)，吸烟率显著下降(P＜0、01)，接受健康教育率、定期体检率有显著性提高(P＜0．01)；干预前、后成食摄入率、体重超重率、肥胖率间差别无显著性意义(P＞0．05)；定期自我监测体重率、定期监测血压率干预前、后差剐亦无显著性意义(P＞0．05)，高脂摄入率干预后有明显增加(P＜0．01)。结论 家庭医生“合同式健康全程管理示范干预”模式对改善家庭全人群健康知识、信念、行为是有效的、可行的，一般人群、高危人群是家庭干预中的难点人群。

A Study of the Effect and Influential Factors on the Intervention Demonstration of all the Processes in a Contract Health Management in Fangzhuang Community

Objective To study the model of the intervening demonstration of all the processes in a contract health management,among which family physician is regarded as the main line and family as a unit so that fore-and-after intervening synthesized health behavior of family members are carefully observed.Methods 60 freewill families including 205 people contracted with family physicians.SPSS was used to analyze the information which was obtained from August,2003 to December,2004 by means of EPI5 software and questionnaire about lifeway and life-action through checking,the understood ratio of health knowledge and the change of health life-action as well as the popularized risk factors are evaluated;and different kinds of intervening management are also performed according to family health issues discovered by family health diagnosing.Results The understanding ratio of 9 aspects regarding health knowledge is significantly increased ( P <0.01),and smoking occupied is dramatically decreased ( P <0.01),and accepting health education and trending periodically the body health examination are also notably improved ( P <0.01) after intervening for these family people.Conversely,the ingested salty food,body overweight and fatness ratios are basically not only unchanged ( P >0.05),but self-supervising body weight and blood pressure ratios are also not varied ( P >0.05).However,ingesting over-fatness ratio is distinctively enhanced ( P <0.01).Conclusion The model of intervening demonstration presented in this paper is feasible and effective to reform the health knowledge and persuasion and action for family members;in particular the intensive-care public is relatively to the process for intervening procedure.